International Health Regulations (IHR)

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The International Health Regulations or IHR(2005) is one of the most potent tools to safeguard the world from disease outbreaks and public health emergencies, because it is a legal framework that binds Member countries and WHO to certain obligations aimed at containing the spread of diseases between countries. To fully implement IHR(2005), appropriate legal frameworks are needed at the national level. The challenge is that, countries have very different requirements, and that existing legislation, policies, regulations and requirements currently support IHR implementation to varying degrees. Therefore, WHO SEARO is working with Member States to review the current status of national legal frameworks to support IHR implementation, identify gaps, and provide guidance on how authorities might revise their legal instruments.

Building outbreak response capacity in SEAR

The IHR (2005) requires WHO to respond to any Member State request for support to an outbreak, but large events can easily outstrip WHO internal capacity. To help address this, a training workshop on “Strengthening Regional Capacity for Outbreak Response”, was held from 27 Nov to 3 Dec 2012, in Medan and Berastagi, Indonesia, to train experts who can be deployed at short notice. The training, conducted in collaboration with the Global Alert and Response Network (GOARN), included a realistic simulation of an outbreak ‘in the field’. Subsequently, many of the 24 participants, who are from the SEA Region, and from Cambodia, China, Japan and Singapore, have been identified as suitable for future deployment by WHO in the event of an outbreak.

Fourth Regional Meeting on the Implementation of the International Health Regulations (2005)

The fourth Regional Meeting on the Implementation of the International Health Regulations (2005) was held on 7-9 December 2011, in Bangkok, Thailand. In his opening remarks, Dr Samlee Plianbangchang, Regional Director, WHO South-East Asia, said , “An important requisite for effective implementation of IHR by Member States is the core capacity of countries. Such capacity should have a mechanism for efficient inter-sectoral coordination, as well as an appropriate legislation to ensure effective enforcement of necessary measures.” He emphasized the need to strengthen core capacities as a priority.

With the support of WHO, the 194 States Parties to the International Health Regulations (IHR) have been implementing these global rules to enhance national, regional and global public health security. Key milestones for the countries include the assessment of their surveillance and response capacities and the development and implementation of plans of action to ensure that these core capacities are functioning by 2012.

Background

The purpose of the International Health Regulations is to ensure the maximum security against the international spread of diseases with minimum interference with world traffic. Its origins date back to the mid-19th century when cholera epidemics overran Europe between 1830 and 1847. These epidemics were catalysts for intensive infectious disease diplomacy and multilateral cooperation in public health, starting with the first International Sanitary Conference in Paris in 1851.

Between 1851 and the end of the century, eight conventions on the spread of infectious diseases across national boundaries were negotiated. The beginning of the 20th century saw multilateral institutions established to enforce these conventions, including the precursor of the present Pan American Health Organization (PAHO).

In 1948, the WHO constitution came into force and in 1951 WHO Member States adopted the International Sanitary Regulations, which were renamed the International Health Regulations in 1969. The regulations were modified in 1973 and 1981. The IHR were originally intended to help monitor and control six serious infectious diseases: cholera, plague, yellow fever, smallpox, relapsing fever and typhus. Today, only cholera, plague and yellow fever are notifiable diseases.

The purpose and scope of the IHR (2005), which came into effect in 2007, are “to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks, and which avoid unnecessary interference with international traffic and trade."